Brain: Core of our Conscience

Modern scientific discoveries are advancing our fundamental knowledge on one of the most complex, unique, and enigmatic organs that each individual carries – the brain. Research on the brain is constantly evolving and we have come to a point where bioethicists, specifically neuroethicists, must carefully consider the various ethical issues related to treatment, study, and public policy. 

Since before 495 BC, philosophy was a common field of study. The term — philosophy — is believed to be coined by Pythagoras. We use philosophy, intertwined with religion, to understand the fundamental nature of our actions – free will – and beliefs. “One must remember that neuroscience — and all sciences — arose from a field called ‘natural philosophy,’” says James Giordano, Chief of the Neuroethics Studies Program at Georgetown University. For centuries, philosophers have been debating the truth behind logic, free will, choice, knowledge and many more. But now with the revolutionary studies associated with the brain, such as biomarkers, EEG, MRI technology, etc, neuroscientists are unlocking a field that may help understand the material aspect  — the brain — and how it associates with the debates of philosophers. 

In order to treat a  patient who is awake and not in critical condition, informed consent is required to proceed with any procedure or experiment. Informed consent, whether for a procedure, a trial or sexual activity, means the person understands the facts, implications and future consequences of the action. If the patient comes in with a broken leg and the doctor asks for their consent on moving forward with the appropriate treatment, the patient is using their decision making center, located in the brain, to provide the doctor with the answer. But what if the patient has Alzheimer’s or Parkinson’s? How can the organ that provides consent be the one getting treated? The brain may not have the ability to properly consent. Should the doctor be allowed to proceed with their course of treatment? What about patients with a mental illness such as psychosis? To what “level” of pain or illness should doctors reanalyze the consent and course of treatment? It is the job of neuroethicists to consider these difficult scenarios and to find the best course of action that will keep the patient out of harm’s way. 

Benchmarking the Brain

When doctors determine whether a patient has a mental illness or disease, they are comparing the patient’s brain scan to one of a “healthy” person. Science is constantly evolving and people are constantly adapting, so how do doctors determine what the “benchmarked” brain should look like? When determining what is normal vs abnormal, ordered vs disordered, and functional vs dysfunctional, scientists use their neurological tools along with their natural human instinct to be influenced by society. These scientists and doctors that are identifying the benchmarked human brain, are predominantly white men in western countries, due to the countries’ advancements in the medical field. Therefore the benchmark determined by these medical scientists is limited by the people and the region they live in. Would the resulting outcome of the benchmark brain be the same if the doctors were living in Africa or South East Asia, and were looking at a different demographic of patients? What if the brain samples were primarily of deaf people, won’t this change the benchmark? What if the doctor was deaf, would this impact how he evaluates the brain? How do neuroscientists indefinitely adapt these benchmarks to fit with the evolving societal norms? As science continues to change, there are only more questions to ask. 

Originally, research was primarily conducted in either Europe or the United States. As defined in natural selection and adaptation, communities in various parts of the world have different features and abilities. The research concluded in Europe and the United States could be drastically different than if the experiment was conducted in, for example, China. Lately, neuroscience has been becoming more diverse and these group experiments have been taking place in China, South American, Africa, and India. These regions have different philosophies, beliefs, histories, and perceptions on the world, all influencing the conclusions of the experiments which may be drastically different than those in other countries. There is no one benchmarked brain, influences of geography and philosophy play a prominent role in identifying the various benchmarks. But in different communities various illnesses may be normalized due to the commonality of it. For example, many people living with hearing disabilities refuse to get the cochlear implant because it is making them feel like they are “unfit” and “abnormal” within society. Implementing a “cure” for deafness would inherently erase deaf culture, which includes: poetry, language, art. Decisions of whether to introduce and produce cures to treat such “disabilities” has been an ongoing debate amongst bioethicists across the globe.  

Can a Brain Decide to be Brain Dead?

There are many “abnormal” and “dysfunctional” illnesses and disabilities that are prevalent in every community and sometimes being set free from the pain surpasses living with it. Euthanasia – the practice of intentionally ending a life with the assistance of a physician – is a practice that has been becoming more prevalent in countries across the world. It is legal in 33 countries including parts of the United States. There is a big debate around the ethics and morality of euthanasia amongst religious leaders/scholars and policy makers, and a large role of bioethicists is to look at all the sides of such practices. Firstly, to make such a decision, where there is no turning back, the patient must be in the right state of mind – informed consent is required, so what if the patient was terminally ill with a neuro disease? Are they capable of making such an important decision? With chronic illnesses, the brain is deeply impacted and may not be eligible to make the decision. Where is the line drawn for such illnesses? Several major religions are highly opposed to the practice of euthanasia as it is seen as denying God’s gift of life by intentionally ending in. Of course, it is the patient’s decision to follow through with euthanasia or not. Only they know the suffering and pain that they are living with and with this available resource it may just save their life. 

Looking at evolving medical technologies just from the angle of medicine is highly underrated and bioethicists are important in looking at the aspects of religion to society to philosophies, to determine and make conclusions on how these advancements should or should not make their way into society. Though the brain is only a mere aspect of our material body, it is the most vital and mysterious organ and is also the most unknown. Each brain is unique and neuroscientists are constantly researching and adapting their conclusions based on their findings; thus requiring neuroethicists to do the same. 

References

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